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New firearms law and mortality study fails to guide next steps

In an invited commentary, Garen Wintemute, an emergency medicine physician and director of the Violence Prevention Research Program at the University of California, Davis, discusses important limitations of a new firearms and crime study linking firearms laws with lower firearm-related deaths.

Effective data-gathering and evaluation of evidence-based interventions led to requirements for seatbelts, airbags and other measures that reduced vehicle traffic fatalities. Wintemute believes the same approaches should be applied to address the firearm violence crisis.

The research on firearm violence laws and firearm-related mortality rates was conducted by Eric Fleegler of Boston Children's Hospital. Both the study and the UC Davis commentary are published online today in the Journal of the American Medical Association (JAMA) Internal Medicine and will appear in journal’s May print edition.

“The main finding is that having more laws on the books is associated with having lower rates of firearm-related homicide and suicide,” Wintemute wrote in his commentary. “This would be an important finding – if it were robust and if its meaning were clear. Ecological studies of association are inherently weak, however, and correlation does not imply causation.”

“In the end, Fleegler and colleagues provide no firm guidance and leave us with more questions than answers. Do the laws work, and if so, which ones? Should policymakers enact the entire package, or just some of the measures?” he said.

Wintemute believes that to prevent firearm violence, research must be substantial and sustained and physician engagement in developing that effort is particularly important. He also believes that some projects should have direct relevance to policy-based and other potential interventions while others should deepen basic understanding of the gun violence problem.

“Better data and data systems are needed,” Wintemute said. “Interventions must be evaluated, and those evaluations must help guide further efforts. Until we revitalize firearm violence research, studies using available data will be the best we have – and they will continue to be inadequate.”

The Violence Prevention Research Program is an organized research program of the University of California, Davis. Our work addresses the causes, nature and prevention of violence. Our current major areas of emphasis are the prediction of criminal behavior, the effectiveness of waiting period/background check programs for prospective purchasers of firearms, and the determinants of firearm violence. Our mission is to conduct research that will further America's efforts to understand and prevent violence.

UC Davis Health System is improving lives and transforming health care by providing excellent patient care, conducting groundbreaking research, fostering innovative, interprofessional education, and creating dynamic, productive partnerships with the community. The academic health system includes one of the country's best medical schools, a 619-bed acute-care teaching hospital, a 1000-member physician's practice group and the new Betty Irene Moore School of Nursing. It is home to a National Cancer Institute-designated comprehensive cancer center, an international neurodevelopmental institute, a stem cell institute and a comprehensive children's hospital. Other nationally prominent centers focus on advancing telemedicine, improving vascular care, eliminating health disparities and translating research findings into new treatments for patients. Together, they make UC Davis a hub of innovation that is transforming health for all. For more information, visit healthsystem.ucdavis.edu.